Zhou Xianting, Zhang Chenxi, Fan Xuekai, Cai Xiaoming, Wang Xin, Pan Jiadong
Department of Plastic Reconstructive Surgery & Hand Microsurgery, Ningbo No. 6 Hospital, Ningbo, China.
Front Surg. 2024 Mar 26;11:1363827. doi: 10.3389/fsurg.2024.1363827. eCollection 2024.
Replantation represents a treatment option for patients with severed finger pulps. However, in some cases, replantation is a challenging task.
We report a successful case of finger pulp reconstruction of the ring finger using free flaps from a nonreplantable index finger in a spare-parts procedure. A 43-year-old worker accidentally injured the index, middle and ring fingers of his left hand on a machine turntable. The severed index and middle fingers and the distal pulp of the ring finger could not be replanted due to extensive contusion of blood vessels and soft tissues. After vascular and nerve anastomosis, a free skin flap isolated from the nonreplantable index finger was transplanted to the wound of the distal pulpal defect of the ring finger. The flap survived completely postoperatively. Six months after the operation, only a slight deformity of the ring finger was observed. Moreover, sensation of the digit recovered well.
Spare-part surgery is a surgical approach that effectively saves and utilizes tissue that would otherwise be discarded in cases of severe limb trauma. This idea may be applied to treatment of severe injuries to multiple fingers. Additionally, in the process of tissue transplantation and repair, attention should be given to protecting the tissue in the recipient area to avoid damage to the original undamaged tissue structure, which can adversely affect healing and recovery of the tissue.
再植是手指末节离断患者的一种治疗选择。然而，在某些情况下，再植是一项具有挑战性的任务。
我们报告了一例通过备用部件手术，使用不可再植示指的游离皮瓣成功重建环指手指末节的病例。一名43岁的工人在机器转盘上意外致左手示指、中指和环指受伤。由于血管和软组织广泛挫伤，离断的示指和中指以及环指远节指腹无法再植。在进行血管和神经吻合后，将从不可再植示指分离的游离皮瓣移植到环指远节指腹缺损的伤口处。术后皮瓣完全存活。术后6个月，仅观察到环指有轻微畸形。此外，手指感觉恢复良好。
备用部件手术是一种外科手术方法，能有效挽救和利用在严重肢体创伤情况下原本会被丢弃的组织。这一理念可应用于多手指严重损伤的治疗。此外，在组织移植和修复过程中，应注意保护受区组织，避免损伤原本未受损的组织结构，否则会对组织的愈合和恢复产生不利影响。
